Provider Demographics
NPI: | 1154042257 |
---|---|
Name: | THERAPY CARE LTD |
Entity type: | Organization |
Organization Name: | THERAPY CARE LTD |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | MANAGING DIRECTOR |
Authorized Official - Prefix: | |
Authorized Official - First Name: | ERIC |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | CHESTER |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 630-761-0900 |
Mailing Address - Street 1: | 1001 E WILSON ST STE 100 |
Mailing Address - Street 2: | |
Mailing Address - City: | BATAVIA |
Mailing Address - State: | IL |
Mailing Address - Zip Code: | 60510-3157 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 630-761-0900 |
Mailing Address - Fax: | |
Practice Address - Street 1: | 1001 E WILSON ST STE 100 |
Practice Address - Street 2: | |
Practice Address - City: | BATAVIA |
Practice Address - State: | IL |
Practice Address - Zip Code: | 60510-3157 |
Practice Address - Country: | US |
Practice Address - Phone: | 630-761-0900 |
Practice Address - Fax: | 630-761-0909 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | Yes |
Parent Organization LBN: | THERAPY CARE LTD |
Parent Organization TIN: | <UNAVAIL> |
Enumeration Date: | 2022-09-07 |
Last Update Date: | 2022-10-17 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 261QM1300X | Ambulatory Health Care Facilities | Clinic/Center | Multi-Specialty | |
No | 224Z00000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapy Assistant | Group - Multi-Specialty | |
No | 225100000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | Group - Multi-Specialty | |
No | 2251P0200X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | Pediatrics | Group - Multi-Specialty |
No | 225X00000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist | Group - Multi-Specialty | |
No | 225XP0019X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist | Physical Rehabilitation | Group - Multi-Specialty |
No | 225XP0200X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist | Pediatrics | Group - Multi-Specialty |
No | 2355S0801X | Speech, Language and Hearing Service Providers | Specialist/Technologist | Speech-Language Assistant | Group - Multi-Specialty |
No | 235Z00000X | Speech, Language and Hearing Service Providers | Speech-Language Pathologist | Group - Multi-Specialty |
Provider Identifiers
State | Identifier ID | ID Type | Issuer |
---|---|---|---|
FL | 1106771-00 | Medicaid |